Really, not exercising is worse than smoking?

Deb Holmes

Posted:
10/25/2018 03:00:20 PM MDT

High Altitude Health Deborah Holmes MedX of Estes

I've been all over this most recent study done by the Cleveland Clinic and published in JAMA (Journal of the American Medical Association) Network Open, last Friday. The many headlines that the news agencies have focused on include, "not exercising may be worse for your health than smoking." Variations of this topic, but all the same emphasis.

As you can only imagine, my blood is boiling as I try to get to the bottom of what this research is saying. Because, I'm sorry, smoking is ultimately one of the worst things you can do for your health and I can't believe that a lazy, non-exercising, non-smoking person's health would be worse than a smoking person's.

Starting at the Cleveland Clinic publication itself, the study they published was actually a longevity study of 122,007 patients between the years of Jan. 1, 1991 through Dec. 31, 2014. The study's focus was on cardiorespiratory fitness correlating to longer life spans. The researchers wanted to look at the effects of extreme exercise on longevity.

What they found was that better cardiorespiratory fitness (CRF) leads to longer life and there are no limits to how much exercise might be too much.

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"The study found that increased CRF was directly associated with reduced long-term mortality, with no limit on the positive effects of aerobic fitness. Extreme aerobic fitness was associated with the greatest benefit, particularly in older patients (70 and older) and those with hypertension." Countering what several studies have suggested that extreme exercise can be associated with certain adverse cardiovascular findings, such as atrial fibrillation and coronary artery disease and might shorten lives.

This study found that extreme fitness provided additional survival benefits over more modest levels of fitness, and that extremely fit patients lived the longest.

The patients had all undergone a stress test at the Cleveland Clinic. From these results the patients were split into five performance groups, according to how they did on their treadmill stress test. The groups included elite, high, above average, below average and low performers. How they did on their stress test, is a good indicator of their overall physical fitness levels.

Elite performers were defined as having an aerobic fitness level in the top two and half percentage by age and gender and demonstrated fitness levels comparable to endurance athletes. The remaining performance subgroups were split approximately by 25 percent of the research population.

What the study did show was when the subgroups were analyzed by age, the survival benefit of elite versus high performance was most notable in older patients. "In those over the age of 70, elite performers had a nearly 30 percent reduced risk of mortality compared to high performers. In younger age groups there was no statistical difference in the outcomes between elite and high performers."

The study also added in comorbidities (health issues these patients might have/had during this study trial) and they discovered that "all-cause mortality inversely related to CRF and was lowest in the elite performers. Even those patients with hypertension, the elite performers again showed a nearly 30 percent reduction in all-cause mortality compared to high performers. In all other comorbidity subgroups there was no statistical difference in survival rates between elite and high performers."

I'm still trying to find where smoking is better than non-exercise connection in this research. Dr. Wael Jaber, co-author of the study stated in one of the interviews I read in the Time Magazine article says; "the results are surprising. Being unfit on a treadmill or in an exercise stress test has worse prognosis, as far as death, than being hypertensive, being diabetic or being a current smoker."

His generic statement leaves me wondering; 'current smoker' versus a 'life-long smoker' without indication whether the smoker might also exercise? As I've written in previous articles, even if you are a smoker you can still be healthier if you exercised on a regular basis. Now being sedentary and a smoker must be worse than being a non-smoking, non-exerciser?

"Although it is widely understood that an active lifestyle can lead to a healthy life, the study concludes that a sedentary lifestyle is the equivalent of having a major disease and it's simplest cure is to start exercising."

Crazy that the media picked up on that quote, instead of the true outcome of the study!

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